Basic Information
Provider Information
NPI: 1689878381
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STOFFERS
FirstName: PATRICIA
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3200 N CENTRAL AVE
Address2: SUITE 900
City: PHOENIX
State: AZ
PostalCode: 850122425
CountryCode: US
TelephoneNumber: 6024063729
FaxNumber: 6027989412
Practice Location
Address1: 500 W THOMAS RD
Address2: SUITE 800
City: PHOENIX
State: AZ
PostalCode: 850134224
CountryCode: US
TelephoneNumber: 6024063715
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/14/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LW0102XRN125283AZY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health

No ID Information.


Home